Ministers are planning a review of NHS staffing levels in Scotland amid reports of chaos in hospitals over Christmas and the new year.
Shona Robison, the Scottish health secretary, is to order a rethink of the way the whole health and care system — including social services — is staffed over the festive period to ensure “better” care for patients in future.
The move follows widespread concern about the pressure on hospital capacity this month, with patients waiting on trolleys overnight in some accident and emergency departments and many patients parked on the wrong wards for their medical problems because of bed shortages. The Royal College of Emergency Medicine (RCEM) for Scotland and representatives of out-of-hours GP clinics called for an overhaul of the services that were available over the recent long bank holiday weekend.
Speaking before publication of the latest A&E waiting times figures, Ms Robison said: “The first couple of weeks back in January are always the toughest during the winter period for a variety of factors including the fact of the limited opening over Christmas and new year of various services. This year is no different.”
She said that the scale of delays experienced by patients waiting in emergency departments was similar to last year in Scotland. However, she added: “We always do a winter debrief and lessons learnt and as an early lesson learnt I want to kick off a review looking at how we improve matters in the first few weeks of January.”
She said it was “absolutely fair to say” of the performance in the first two weeks of this month that “we can do better around that for patient outcomes by looking at how the system works at the moment”.
Over Christmas and new year a range of services including GP surgeries, social services and some hospital departments run at a reduced level for eight days out of 11.
Ms Robison acknowledged that “vast numbers” of NHS and care staff did go into work during the public holidays and said their contribution must be remembered but she added: “What we need to determine is how these [festive] closures impact on our hospitals and accident and emergency services and if better practices can be identified to ensure both staff and patients can start the new year in a better position.”
The review, in which Alan Hunter, NHS Scotland performance director, is expected to take a lead role, will consider all elements of the service including GPs, social care services and hospital departments, including those that play a role in the discharge of patients such as pharmacy departments.
The review is expected to consider financial implications, such as premium payments for working public holidays, but Ms Robison stressed that the solutions had to be sustainable. She said: “If there are any sensitive issues these issues will be taken forward in the usual way.”
She is expecting recommendations in the spring, to prepare for implementation next Christmas, and said that the changes could also apply to other public holidays, such as Easter.
She was keen to distinguish the approach from that taken in England where GPs are being told to open seven days a week amid a crisis in hospital capacity, saying that one staff group should not be singled out.
Martin McKechnie, vice-president of RCEM Scotland, said: “I welcome any progress in delivering the correct service to patients at the correct time.”